This document discusses culture, generational differences, and spirituality in nursing leadership and management. It defines culture and discusses the importance of cultural competence in healthcare. Generational differences among Traditionalists, Baby Boomers, Generation X, and Generation Y are reviewed. The document also discusses the importance of integrating patients' spiritual beliefs into culturally competent nursing care and being aware of potential spiritual distress.

1. Culture, Generational
Differences and Spirituality
Nursing Leadership &
Management
Chapter 16

2. Objectives:
Upon completion of this presentation, the ADN nursing
student will be able to:
• Define culture
• Understand race and ethnicity and health care
disparities.
• Discuss cultural competence
• Identify key cultural nursing theories and theorists

3. Objectives:
• Discuss organizational culture
• Review strategies with working within a multicultural
team
• Review generational differences and perceptions
• Integrate spiritual beliefs into culturally competent
nursing care.

4. What is Culture?
Integrated lifestyle that includes:
• Learned and shared beliefs
• Values, world views, knowledge
• Artifacts, rules, and symbols
• Passed from generation to generation

5. Culture
• Guides the behavior of a
particular group of people
• Incorporates the
experiences of the past and
influences the present
• Explains patterns of
thoughts and actions
• Contributes to the group’s
physical and social activities

6. The Development of Culture
• Culture is learned and
shared from parents,
teachers, religious and
political leaders and
respected persons.
• Normally, children learn
as they are growing up.
Families

7. What is a Subculture?
Smaller groups within a culture that may be based on:
• Professional and occupational affiliation
• Nationality or race
• Age group
• Gender
• Socioeconomic factors
• Political views
• Sexual orientation

8. What is Cultural Shock?
What is Cultural Shock?
Develops when values
and beliefs upheld by
new culture differ
radically from person’s
native culture.
Ways to alleviate cultural shock?
Newcomers can
assimilate into the new
culture by learning the
new culture’s
important values.

9. What is Race and Ethnicity?
• Race-geographical or global human population
distinguished by human traits and physical
characteristics.
• Ethnicity-identification of person or group based on
racial, tribal, linguistic, religious, national or cultural
group.

10. Population of the United States by Race and
Hispanic/Latino Origin, Census 2000 and 2010
• White 63.7% [2010] and 75.1% [2000].
• Black/African American 12.2% [2010] and 12.3% [2000].
• American Indian/Alaska Native 0.7% [2010] and 0.9% [2000].
• Asian 4.7% [2010] and 3.6% [2000].
• Native Hawaiian/Pacific Islander 0.15% [2010] and 0.1%
[2000].
• Hispanic/Latino 16.3% [2010] and 12.% [2000].
U.S. Census Bureau: National Population Estimates: Decennial Census.

11. What are Health Care Disparities?
• Cultural beliefs that can cause marginalization
or separation from mainstream health care.
• Marginalization groups often suffer high rates
of morbidity, mortality and disease due to:
lack of health care access, inadequate
financial resources, immigrant status and lack
of knowledge of available resources.

12. Differences in Health Risks and Health Status
According to, the Office of Minority Health and Health
Disparities (OHMD, 2010), death rates for the black
population of the U. S. surpassed the white population
by:
• 48% for cerebrovascular disease
• 31% for heart disease
• 21% for malignant neoplasms
• 113% for diabetes

13. Differences in Health Risks and Health Status
According to the U.S. Census Bureau (2011), the
following groups of people live below the poverty line:
• 30% of Native American Indians
• 29.5% of Hispanics
• 14.1% of Asian/Pacific Islanders
Compared to:
• 9.8% of the White population

14. Diversity in Nursing
• Most nurses are
Caucasian women
• 6.2% male nurses
• 10.9% Blacks are
highest minority
American Association of Colleges of Nursing
(AACN, 2010).

15. Language
In the United States:
• 80% of the population speaks English
• Of the remaining 20%, 62% speak Spanish
*Provide an interpreter, it is a guaranteed right
under Title IV of the Civil Rights Act of 1964

16. What is Culturally Competent Care?
A complex integration of
knowledge, attitudes and
skills that extend across
cultural lines, according to
the American Academy of
Nursing (AAN, 1992)
http://youtu.be/Dx4Ia-jatNQ
Care that is:
• Designed for the specific
patient.
• Based on the unique culture
of that patient
• Provides cultural sensitivity.
• Provides the patient
empowerement to make
decisions (AAN, 1992)

17. Nursing Education in Cultural Diversity
• Since the 1960s, nursing education has included
cultural diversity and sensitivity concepts in it’s
curriculum.
• The National League of Nursing Accrediting
Commission, Inc. (NLNAC, 2008) has made cultural
diversity training mandatory for accreditation.
• Cultural nursing theories and theorists help to guide
nurses to manage, understand and lead culturally
sensitive workplaces.

18. Organizational Cultural
Culture
• A system of shared values
and beliefs that influence
the behaviors of its
members.
• Values, existence,
resources, degrees of
change and strength set the
culture.
Socalization
• Workplace culture.
• Strong and shared mission,
vision and goals.
• Sensitive to culturally
unique staff.
• Perceptions of
responsibilites and roles is
important.

19. Generations
• Generations are groups
that share birth years,
age, locations and
significant life events.
• Approximately, 15 to 20
years in length.
• Value systems differ.

20. Generational Perceptions
Traditionalists
• Born before 1940s
• Born after the Great
Depression
• Raised with discipline to
obey orders
• Obligated to conform
• Work is a duty
Steady

21. Generational Perceptions
Baby Boomers
• Born between 19440 and
1960
• Grew up in educational and
economic expansion
• Work for challenge and
career advancement
• Largest generation with
financial impact
Careers

22. Generational Perceptions
Generation X
• Born between 1960 and 1980
• Self Reliant and independent
• Look for career security not
job security
• Willing to change jobs, loyalty
to oneself not employers
• Want technologically current
work environment
Independent

23. Generational Perceptions
Generation Y
• Born after 1980
• Children of Baby Boomers
• Grew up at the end of the
Cold War
• Speak your mind philosophy
• Focus on early retirement
• Mantra is change
• Expect countless options
Speak your mind

24. Generational Perceptions
Generation Z
• Born in late 1990s
• Born during technology
• Have a multi-cultural
and multi-racial friends
• Do not believe in the
“American Dream”
Technology

25. Spirituality
• Component of healing
in most every culture
• Important assessment
during hospitalization
• Nurses can use
resources for spiritual
support

26. Spiritual Distress
• Recognized as a North American Nursing
Diagnosis (NANDA)
• Identifies when a person has impaired ability
to integrate meaning and purpose in life with
self, others, art, music, literature, nature or
power greater than oneself.
• Help to connect patients spirituality with
method such as meditation, prayer,
participation in religious services or rituals.

27. Champion Spirituality
• Provide holistic care
to patients and
fellow staff.
• Develop
understanding and
empathy for others
spirituality.

28. References
Association
American Academy of Colleges of Nursing (AACN). (2010). Race/Ethnicity of students enrolled in generic (entry-level)
baccalaureate, master’s and doctoral (research-focused) programs in nursing, 2001-2010. Retrieved from
http://www.aacn.nche.edu/research-data/EthnicityTbl.pdf
Kelly, P. & Tazbir, J. (2014). Essentials of nursing leadership & Management (3rd ed.). Clifton Park, NY: Delmar
NLNAC accreditation manual. (2008). National League of Nursing Accrediting Commission,, Inc. Retrieved from
http://www.nlnac.org/manuals/NLNACManual2008.pdf
Office of Minority Health & Health Disparities [OMHD]. (2010). About minority health. Retrieved from
http://www.cdc.gov/omhd/AMH/SMH.htm
U.S. Census Bureau. (2007). American community survey. Retrieved from http://www.census.gov/acs/www
U.S. Census Bureau. (2011). 2010 census data.gov/2010census/data/